Alaskans urge health care changes
Alaskans who crowded the Wilda Marston Theatre on Saturday told Sen. Mark Begich overwhelmingly they wanted Congress to create a "public option" for health care as an alternative to the nation's existing system based on private insurance.
The question of whether health care reform should include a public health insurance plan to compete with private insurers is drawing intense attention. President Obama strongly favors it and most congressional Republicans are opposed, with the sides sparring over cost, fairness and quality of care.
Begich, an Alaska Democrat, on Saturday held a "town hall" forum on health care at the Anchorage venue as the debate over the issue rages nationally. Begich said there are many ways to have a public option and it doesn't mean a government takeover of the health care system. He suggested an idea that was part of his campaign for the U.S. Senate last fall: letting members of the public buy into the health benefit program federal employees use.
"It's such a big group, we are able to negotiate a lot of our cost factors," Begich said.
The theater, which has a capacity of about 230, was almost full for the forum. Begich asked audience members to raise their hands if they supported a "public option" -- which he broadly defined as something that was not owned and operated by the insurance companies. The vast majority of people raised their hands.
Alaska Republican Sen. Lisa Murkowski was also in Anchorage talking about health care, holding a Friday discussion with local providers of health care. Murkowski, who is on the health committee in the U.S. Senate, brought up the proposed bill presented to her committee that's estimated to cost more than $1 trillion over 10 years but cover only about one-third of those Americans lacking health insurance. Democrats have protested that the bill is incomplete and the estimate doesn't include money savers to be added later, but there's still sticker shock.
"We want to know how we're going to pay for it, that's a big problem," Murkowski said. "And, if in fact we accept that this is the route that we go, are we really providing for better health care? ... We're not convinced that we're getting good quality care with the proposal that's out there."
Murkowski said there's no disputing health care reform is needed, it's a question of what to do.
"Health care reform is going to be expensive, we know that. But we also know doing nothing is not really an option, that too is incredibly expensive," she said.
Murkowski said Alaska has a big problem as it is in dealing with the federal Medicare program, which pays providers about two-thirds as much as private insurance.
A recent study by the University of Alaska Anchorage found only 13 of 75 primary care doctors surveyed in Anchorage were willing to take new Medicare patients. Most Americans 65 or older have to use Medicare as their main insurance, and the number of Alaskans of that age is growing fast, the report said.
Joel Gilbertson of Providence Health System argued that a public plan option would not work in Alaska if it is based on Medicare. There is a need for reform but it shouldn't be about loading more people into a system that's broken, Gilbertson said.
Begich said there is no single bill or proposal that Congress is considering. There are many ideas and no consensus about which direction to go, he said. But "it is clearly our number one priority to deal with before the year is out," Begich said. There are about 115,000 Alaskans who don't have health insurance coverage, he said.
Stan Loudon, an audience member at Begich's town hall, told the senator that the government can't provide quality care now and a government plan would squeeze out the private insurance plans.
"The government is not here to help me," Loudon said.
Begich said people who have insurance are already paying an average of around $1,000 more a year because of the health care costs of the uninsured.
"You're paying for the uninsured now ... the question is do we want to have a fairness and equity in this," he said.
Begich said there needs to be balance and he doesn't support a "single-payer" system -- a system in which the federal government provides health insurance for all Americans. Begich said the political reality is that he doesn't see it happening.
Several people at the town hall meeting said something has to be done about Medicare, with one internist suggesting all senators go on Medicare for two years and "see where the shoe pinches."
A new medical school graduate said the current health care system rewards specialists and steers people away from primary care, as well as giving doctors incentives to order more and more tests for fear of malpractice suits, driving up costs.
David Landry told Begich that a public insurance option is the right thing for the nation's health care and that the U.S. House is way ahead of the Senate in the effort. Earl Kygier said he watched the effect of industry lobbyists on the prescription drug debate and fears how it is going to play out on health care reform.
"What is Congress going to do about all those lobbyists? ... Those people are there every day in your face," he said.
TOWN HALL MEETING: Most want an alternative to insurance companies.